Health & Welfare Plans Newsletter

November 29, 2017

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[Official Guidance]

Text of CMS Draft Bulletin: Proposed Timing of Submission of Rate Filing Justifications for the 2018 Filing Year for Single Risk Pool Coverage Effective on or After January 1, 2019 (PDF)
"This bulletin proposes guidance for purposes of establishing the submission deadline ... for health insurance issuers to submit Rate Filing Justifications for single risk pool coverage in the individual and small group markets. This bulletin also proposes the dates on which CMS will provide public access to information regarding proposed rate changes and final rate changes for single risk pool coverage, as well as the date for States with Effective Rate Review Programs to post proposed rate increases subject to review."
Center for Consumer Information and Insurance [CCIIO], Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

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[Official Guidance]

Text of CMS Proposed Key Dates for Calendar Year 2018: QHP Certification in the Federally-Facilitated Exchanges; Rate Review and Risk Adjustment (PDF)
"This document summarizes key dates for calendar year 2018 regarding some activities and policies that are outlined in other documents that have not yet been finalized ... CMS is not soliciting additional comments on the substance of the underlying policies or the proposed key dates through release of this document."
Center for Consumer Information and Insurance [CCIIO], Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

CMS Posts 2019 Draft Letter to Issuers
"Where it differs from the 2018 letter, it generally does so insofar as it incorporates changes contained in the proposed 2019 Benefit and Payment Parameters Rule. These changes generally either remove earlier federal requirements ... or transfer to the states responsibilities such as ensuring compliance with network adequacy or essential community provider requirements. The letter identifies areas where states performing plan management functions may follow an approach different from that set out in the guidance[.]"
Timothy Jost, in Health Affairs

Rhode Island Becomes Eighth State to Enact Paid Sick Leave Law
"Many other states have enacted 'preemption' measures that ban jurisdictions within their borders from enacting their own paid sick leave laws. Of the 20 states that have enacted such measures to date, only Oregon and Rhode Island have paired the local ban with a statewide paid sick leave mandate.... [A map] depicts the states with paid sick leave preemptions laws, and the ever-increasing patchwork of state and local paid sick leave laws, which will likely expand in the absence of a federal mandate."
Willis Towers Watson

Proposed National Paid Leave and Flexible Work Options Law Would Preempt State Leave Laws
"Three Republicans from the House of Representatives hailing from states with paid family and sick leave laws have sponsored the Workflex in the 21st Century Act, signaling increasing frustration with the complexities of multi-state compliance.... In its current form, the bill would serve to drastically reduce employee access to paid leave, but would also grant employees alternative work arrangements, known as 'workflex' options."
Seyfarth Shaw LLP

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Navigating the Section 1332 Waiver Process: For States, a Treacherous Road Ahead
"In light of the mounting legislative efforts to make changes to the section 1332 waiver process, especially in the Alexander-Murray market stabilization package, and enhanced state interest in availing themselves of this opportunity, [this article provides] an overview of this aspect of the [ACA], the record of how state applications have been adjudicated so far, and the prospects of change to the policy in the near term. Unfortunately, given the considerable uncertainty in both the legislative and executive branches regarding the future of these waivers, states cannot safely expend meaningful resources on developing new applications for the program at this time."
Health Affairs

Health Insurers to CMS: Your Changes Will Confuse Consumers, Hurt Markets
"[I]nsurers that sell plans on the individual and small group markets said they are afraid they will bear the burden for greater healthcare costs if CMS follows through with plans to allow states to define their own benefits annually starting in 2019."
American Journal of Managed Care

[Opinion]

American Academy of Actuaries Comments to CMS on Notice of Benefit and Payment Parameters for 2019 (PDF)
12 pages. "The proposed rules define a typical employer plan as one with at least 5,000 enrollees. It may be appropriate to add additional criteria.... The [minimum value calculator (MVC)] has not been updated since its initial release, and is expected to be used to determine the minimum value of employer group plans. The [actuarial value (AV)] calculator has been updated numerous times, and now the two are out of synch. [It] would be appropriate to update the MVC on a regular basis, similar to the AV calculator update schedule."
American Academy of Actuaries

[Opinion]

What Would Uwe Reinhardt Say About Walmart's Company-Sponsored Health Coverage?
"With average wages of $13.85 per hour ($28,808 per year if working 40 hours per week with paid vacations), they expect a worker with a child to pay $7,242 in health care costs ($1,742 towards the premium and $5,500 in cost sharing). That is one-fourth of the family's meager income! ... This is a prime example of the escalating shift to consumer-driven health care. It is not as if we didn't understand the issues long ago."
Physicians for a National Health Program [PNHP]

Benefits in General

DOL Delays Implementation of Disability Claim Rules
"Many short-term disability arrangements are merely payroll practices where the employer continues the employee's normal salary for several weeks or months while the employee is disabled. The new rules won't apply to these arrangements but apply to arrangements where an insurer pays benefits....[N]onqualified deferred-compensation plans that pay benefits when a participant becomes disabled are subject to these new regulations if the determination of disability is made by an insurer or by the employer or plan sponsor."
Lockton

Executive Compensation
and Nonqualified Plans

2017 Executive Benefit Survey Results (PDF)
16 pages. "The perceived effectiveness of [nonqualified deferred compensation plans (NQDCPs)] continues to climb higher each year, with 2017 survey responses maintaining that over 80% of plan sponsors believe that their NQDCPs were effective or extremely effective ... An average of 44% of responding companies offered a company match, ... Informal funding continues to be a popular strategy for addressing NQDCP benefit obligations[.]"
Prudential

Discussions
on the BenefitsLink Message Boards

Modify Term of Stock Option Award?
Can a stock option award be amended to extend the term AFTER the original expiration date? Set aside any ISO/NQSO and accounting issues for now, I'm just trying to determine if it can be done. Award agreement states that option expires upon the earlier of 10 years from the date of grant, or the expiration date shown on the grant notice. Grant notice shows a date about 3 months earlier than 10 years from date of grant (related to date vesting begins). Example: Grant date is 12/31/2017. Expiration date (as shown in grant notice) is 10/1/2017. Can this award be amended to extend the expiration date to 12/31/2017?
BenefitsLink Message Boards

Press Releases

ICI Names Susan M. Olson General Counsel
Investment Company Institute

Meridian Promotes Two Lead Consultants to Partner
Meridian Compensation Partners, LLC

PBGC to Pay Benefits for the Public Service Mutual Pension Plan
PBGC [Pension Benefit Guaranty Corporation]

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David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2017 BenefitsLink.com, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

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